The safe handling of medicines in social care settings

Welcome to our webpages which aim to support care providers in managing medicines safely in all social care settings. The information will assist managers to meet the fundamental standards in relation to medicines management. 

If you require information or support on medicines management in social care setting please contact the Medicines Management Team at hardccg.nymm.socialcare@nhs.net

National Resources

The Care Quality Commission (CQC) The sector regulator. The website is where you can find your latest published CQC report, information on the judgement framework and the latest news from CQC. They also provide

National Institue for Health and Care Excellence (NICE)  produces guidance for social care. including:

The Royal Pharmaceutical Society (RPS) has guidance available The handling of medicines in social care.

FOR NURSES: The Nursing and Midwifery Council (NMC) is the professional regulator for registered nurses. It publishes

Central Alerting System (CAS): This service alerts providers to safety information including drug alerts. Providers should ensure they are registered with CAS. Information on how to do this can be found in the CAS Helpsheet for independent health and social care providers.

Electronic Medicines Compendium (eMC) Patient information leaflets (PILs) for most prescribed medicines can be found on this website. When a medicine is dispensed by a pharmacy or dispensing GP a patient information leaflet should be supplied with it, if one exists.  The patient information leaflet should be kept as a reference source for social care staff and service users to refer to.

NHS Choices contains information from the NHS including on health conditions, medicines and social care.

The British National Formulary (BNF) - Online version of this reference source for information on medication.

The internet can be a useful source of information, but you need to be sure that the information is from a reliable source and quality controlled. (Please note: Harrogate and Rural District Clinical Commissioning Group is not responsible for the content of external websites).

Local Guidance

Sample safe handling of medicines policies

Click on the documents below to download sample policies which can be used as a resource to assist managers in developing a policy for the safe handling of medicines in their own service.

** The domiciliary care sample policy and proceedure is being updated and is currently unavailable**

                    

                    

Homely remedies

Click on the links below for the homely remedies policies agreed with the North Yorkshire Local Medical Committee and the CCGs listed below on behalf of the all their GP practices. They can be adopted by care homes for residents registered with any practice in the listed CCGs:

If you want any advice on the implementation of a homely remedies policy in your home please contact Karen Lepper at karenlepper@nhs.net.

Covert Administration

Click on the document to download the covert administration policy agreed by Harrogate and Rural District CCG, Scarborough and Ryedale CCG, Vale of York CCG and Hambleton, Richmondshire and Whitby CCG

Management of Medicines

Storage of medicines: The safe storage of medicines in care homes is essential. A checklist for the risk assessment for storage of dressings, bland emollients and appliances in a person’s room is available here.

Medicines Administration Record (MAR) Chart.

It is essential in any care setting where medication is administered by staff that a MAR chart is used. The provision of the MAR chart is the responsibility of the care provider (although pharmacies often supply them as a complimentary service). For further information see Good Practice Guidance: Medication Administration Records (MAR) in care homes and domiciliary care.

Example MAR chart for care homes (1)  

Example MAR chart for care homes (2)

Example MAR chart for domiciliary care

Signature list for staff involved in the administration of medicines

Controlled Drugs 

Care homes in North Yorkshire and York should report incidents involving controlled drugs to the Controlled Drugs Accountable Officer (CDAO) at NHS England using the online reporting tool.

Care homes should register and login to the reporting tool at https://www.cdreporting.co.uk/reporting/

This does not change the requirement to report incidents to CQC/safeguarding/police as appropriate which should still be done.

Transfer of medicines: When a person moves between providers or goes into hospital it is essential that relevant information accompanies them. A form to help ensure all the relevant information is sent is available here and an example of a completed form is available here.

Oxygen: Useful tips on the storage and use of oxygen are available here. Further advice can be obtained from the oxygen supplier.

Safe recording templates

Clear and accurate documentation is a fundamental part of safe medication practice. The following forms can be downloaded and used by care providers. Click on the title to download the document.

Supplementary information (Protocol) about when required and variable dose medication – It is essential that staff administering medication prescribed to be taken ‛when required’ know what the medication is for and under what circumstances it may be appropriate to administer a dose. The supplementary information document can also be used for variable dose medication to indicate when a higher or lower dose should be given. The supplementary information document should be reviewed on a regular basis and/or if the person’s circumstances change. For further information refer to the pharmacy tip: medication prescribed to be taken ‛when required.

Supplementary Medication Administration Record – As the space on traditional MAR charts is quite limited care providers may find this supplementary record sheet useful as it allows staff to record the time the medicine was administered, the dose and the quantity remaining. If using a supplementary record staff must annotate the main MAR chart with ‛see supplementary sheet’ so all staff record the administration in the same place.

Supplementary sheet for the recording of creams and ointments – Administration of prescribed creams/ointments must be recorded. In some circumstances it may be appropriate to use separate documentation to record the administration. In care homes this may be kept in the person’s room. If using a supplementary record staff must annotate the main MAR chart with ‛see supplementary sheet’ so all staff record the administration in the same place. For further information refer to the pharmacy tip: administration and recording of creams and nutritional supplements

Supplementary sheet for the recording of nutritional supplements – The administration of nutritional supplements such as Fortisip and Ensure must be recorded. In some circumstances it may be appropriate to use separate documentation to record the administration. If using a supplementary record staff must annotate the main MAR chart with ‛see supplementary sheet’ so all staff record the administration in the same place.

Medicines Refrigerator –  Temperature Recording Chart – In care homes the maximum and minimum temperature of the fridge should be recorded daily. Staff must ensure that they always reset the thermometer once the reading has been taken. If the fridge temperature is outside of the required range then action must be taken.

Recording of medicines taken on short periods away from the home – Care homes must be able to account for all the medication for which they are responsible. This form can be used to document medication which the person takes with them for periods away from the home, for example, weekend visits to family.

Staff Competency

It is the responsibility of managers to assess the competency of staff before they are allowed to administer medication – competency assessment tools to support this are available below.

1.• Competency assessment tool for staff working in care homes

          

2.• Competency assessment tool for domiciliary care staff

Information is also available through your local Clincal Commisioning Group websites.

Scarborough and Ryedale CCG  Includes information on nutrition, fortified foods and weight monitoring and an information for care homes page.

Vale of York CCG Includes a section specific to care homes in the Vale of York area  

Airdale Wharfdale and Craven CCG

Hambleton Richmondshire and Whitby CCG

Harrogate and Rural District CCG

 

For further information or queries please email hardccg.nymm.socialcare@nhs.net